=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144276833
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHI-TEH YU M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2006
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19 LIMESTONE DR SUITE 6
-----------------------------------------------------
City | WILLIAMSVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14221-7091
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-630-6660
-----------------------------------------------------
Fax | 716-630-6662
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 323 DAN TROY DR
-----------------------------------------------------
City | WILLIAMSVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14221-3513
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-630-6660
-----------------------------------------------------
Fax | 716-630-6662
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 125371-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------